№3, 2023, volume 19

Objective: to evaluate the association of sequence variants PPARGC1A rs8192678, PPARG2 rs1801282, FTO rs9939609, LEP rs7799039, LEPR rs1137101 with non-alcoholic fatty liver disease (nAFLD) at young adults in Russian population. Material and methods. The case-control study included 100 patients divided into two groups: group 1 (cases) — with nAFLD (n=50); group 2 (controls) without nAFLD (n=50). All subjects underwent a standard ultrasound examination of the liver and ultrasound shear wave elastography (Aixplorer, France) with an assessment of the severity of liver steatosis and fibrosis. Results. We found two sequence variants associated with an increased risk of nAFLD in women: rs9939609 and rs7799039: A/A rs9939609 genotype (OR 5,33; 95% Cl 1,14-24,90; p=0,041) and G/G genotype rs7799039 (OR 7,5; 95% Cl 1,04-54,12; p=0,026). Conclusion. The A/A genotype ofthe rs9939609 gene in young women in the Russian population increased the chance of having nAFLD by 5 times, the G/G genotype ofthe rs7799039 gene increased the chance of having nAFLD by 7.5 times.

Objective: assess an anatomical and topographic parameter of the wound channel formed when using the posterolateral muscular-fascial approach to determine the possibility of its clinical use for performing decompres-sive-stabilizing surgical interventions. Material and methods: on the material of 20 cadavers of both sexes with different body mass index (mean 25.1 ±2.9) aged 54 to 76 years (median 67.5 years), who died from diseases not associated with the pathology of the spine, was modeled the posterolateral muscular-fascial approach to the lumbar spine. During the research were studied wound length, wound depth, wound depth index, access zone and the angle of intersection of the wound edges and the surface of surgical instruments. Results: the average length of the surgical wound during the lateral muscular-fascial approach was 149.75±6.35 mm. The average wound depth was 116.75±8.85 mm. The average value of the index of the depth of the surgical wound with interfascial access is 77.96±5.04. The average area of the intervertebral disc available for removal was 71.2±2.8%. The length of the aperture in the fibrous ring averages 15.8±0.78 mm. The average value of the angle of intersection of the wound edge and the pedicle screw implantation trajectory was 3.15±1.25. Conclusion: the assessment of the anatomical and topographic parameters of the wound channel formed during the posterolateral muscular-fascial approach allows us to conclude that this surgical approach can be used to improve the functional outcomes of decompressive and stabilizing interventions in the lumbar spine.

We present a case of contrast-enhanced ultrasound (CEUS) used in surgery for blood vessels and nerves combined trauma. This case reveals CEUS potential in differentiation of compression-ischemic neuropathy along with perineural fibrosis from intrastem neuroma and complete anatomical interruption of the median and ulnar nerves. CEUS also helped to clarify the vascular lesion — we detected a false ulnar aneurysm and radial artery occlusion. Therefore, the use of CEUS has influenced the surgical management. This method allows expanding the potential for nerve damage diagnostics, and, given further technical progress, has great clinical prospects.

Objective: to prove the possibility of reducing the severity of the course of organ dysfunctions and inflammatory response with the compound L-17 in the model of acute post-manipulation pancreatitis (APMP). Material and methods. The APMP model was made on 40 rats. Animals were divided into control (without treatment) and experimental (with the introduction of the compound L-17) groups of 20 rats. The daily dose of the compound is 40 mg/kg. Results. APMP developed in all animals. In the control group, persistent organ dysfunction and inflammatory response corresponded to a severe course of acute pancreatitis with a mortality rate of 70%. In the experimental group, there was a decrease in the severity of organ dysfunction and inflammatory response, with a decrease in mortality up to 30%. Conclusion. The use of the compound L-17 reduces the severity of organ dysfunction and inflammatory response during APMP in the experiment.

Objective: based on world literature data, to determine the main reasons for patient dissatisfaction with the results of primary knee arthroplasty, and also to propose ways to solve them to increase the level of patient satis¬faction with the results of surgical treatment. Review writing methodology. A search for scientific papers on the subject understudy was carried out in the PubMed and eLibrary databases from 1997 to 2022 using the keywords: "knee-joint", "knee arthroplasty", "gonarthrosis", "epidemiology", "satisfaction", "evaluation methods", "awareness", "forecasting techniques", "results". Full text papers on epidemiology, patient dissatisfaction, and methods for assessing the results of primary knee arthroplasty were analyzed. Conclusion. The main reason for patient dissatisfaction with the results of primary knee arthroplasty is their unfulfilled expectations due to lack of information about the upcoming operation.

Objective: to improve the outcomes of medical rehabilitation of mature second-degree patients with spi¬nal cord injury complicated by emotional-volitional disorders in the long-term period of injury, by applying intrathecal electrostimulation. Material and methods. The results of intrathecal electrostimulation in the treatment of chronic bone pain syndrome complicated by the development of anxiety-depressive disorders in patients with mono- and bisegmental fractures of the A1 and A2 types of lumbar vertebrae (according to Magerl) were studied. Two groups of patients (n=36) comparable in gender, age, and degree of functional impairment in the age range from 45 to 65 years were the objects of the study. Intrathecal electrostimulation was used as monotherapy in the patients of the main group (n=17). Patients included in the comparison group (n=19) received treatment corresponding to stages II-III of medical rehabilitation. Pain intensity was assessed by measuring the electrical potential of the skin and using the VAS scale. The degree of anxiety-depressive disorder was determined by a specialized questionnaire, Simptom Check List-90-Revised. Quality of life was assessed using the Oswestry Disability Index. Results. Positive treatment outcomes in the form of reduced anxiety were achieved in 100% (n=17) of patients in the main group and 53% (n=9) in the comparison group (p=0.05). Pain syndrome was eliminated in more patients in the main group (n=17) compared to (n=11) in the com-parison group. There was a difference in a number of numerical measures of quality of life and patient satisfaction with the treatment received: the value (vector) of the level of rehabilitation potential and the value of the outcome level at p=0.01. Conclusion. An effective, pathogenetically grounded technique for rehabilitation of patients with spinal column injuries was proposed, and the tactics of applying intratissue stimulation to mature and elderly patients with disorders of the emotional-volitional sphere at the outpatient stage of rehabilitation treatment was developed.

Objective: to study the effectiveness of surgical treatment of patients with retinal detachment complicated by macular hole of the PVR B-C, depending on the method of subretinal fluid drainage. Material and methods. We studied the data of 18 patients (18 eyes) with a disease duration of 60±9 days. The size of the macular hole averaged 331 ±38 urn. Group 1 patients (9 patients, 9 eyes) underwent fluid drainage through a central hole, group 2 patients (9 patients, 9 eyes) underwent surgical treatment with drainage through a primary peripheral break. Visual acuity, mi-croperimetry, and optical coherence tomography were used to assess the outcome. Results. In the group 1, the macu¬lar hole remained unclosed in 33% of cases (3 patients), in the group 2-11% of cases (1 patient). In group 1, BCVA increased to 0.09±0.03; in group 2, to 0.11±0.03. According to ОСТ data in the Full Retinal Thick patients of the group 1 a month after the operation, it was 318±42 urn, in the group 2-245±30 urn. Conclusion. Based on the analysis of the results of the study, it can be concluded about the higher efficiency of surgical treatment using the peripheral method of drainage of subretinal fluid.